434. Procalcitonin and Kawasaki Disease: Does PCT Correlate with Coronary Artery Lesions or IVIG Resistant Disease?
Session: Poster Abstract Session: Pediatric Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background: Kawasaki Disease (KD) remains a clinical diagnosis due to the absence of a sensitive and specific diagnostic test.  Acute inflammatory markers are generally elevated in the acute phase of the Illness. There are limited published data on the usefulness of procalcitonin (PCT) for the diagnosis or prognosis of children with KD.  Since PCT is stimulated in response to TNF or IL1-β, and CRP is produced in response to IL6, we hypothesized that PCT might be useful in predicting coronary artery lesions (CAL) and IVIG resistance.

Methods:   74 children with KD who were hospitalized within the first 10 days of illness were retrospectively reviewed and entered into Red Cap Data Base. All patients were diagnosed with KD and treated with IVIG by a Pediatric ID specialist. PCT was measured on stored serum or plasma samples obtained at the time of admission (pre-IVIG).  Samples were batched and run simultaneously on a Kryptor Instrument (Brahms). Data were analyzed to determine if there were statistically significant differences in the incidence of abnormal z scores (> 2.5) or with IVIG resistant disease in KD patients with a PCT value < 0.5 versus > 0.5 mcg/L.  Statistical analysis was done using SAS software.

Results:  PCT values in children hospitalized with acute KD ranged from 0.1 mcg/L to 143.9 mcg/L with a median of 0.54 mcg/L (IQR 0.23-1.29 mcg/L).  There was no correlation of PCT with age, gender, or day of illness at diagnosis.  KD patients with a PCT > 0.5 mcg/L had a significantly higher incidence of IVIG resistant disease (28% versus 6%, p=0.01), but no differences in the incidence of z scores > 2.5. 

Conclusion:  Additional research is needed to establish the sensitivity and specificity of PCT for the diagnosis of KD.  PCT may be of value in predicting which children are at risk for IVIG resistant disease.

Blake Martin1, Samuel R. Dominguez, MD, PhD1, Heather Heizer, PA-C1, Marsha S. Anderson, MD1, Jesse Davidson, MD2, Pei-Ni Jone, MD2 and Mary Glode, MD, FIDSA1, (1)Pediatric Infectious Diseases, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, (2)Pediatric Cardiology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO

Disclosures:

B. Martin, ThermoFisher: provided PCT kits for this project, Research support

S. R. Dominguez, ThermoFisher: supplied PCT kits for this project, Research support

H. Heizer, ThermoFisher: provided PCT kits for this project, Research support

M. S. Anderson, ThermoFisher: provided PCT kits for this project, Research support

J. Davidson, ThermoFisher: received PCT kits for this project, Research support

P. N. Jone, ThermoFisher: provided PCT kits for this project, Research support

M. Glode, ThermoFisher: provided PCT kits for this project, Research support

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